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Review
. 2021 Nov;9(11):e1618-e1622.
doi: 10.1016/S2214-109X(21)00350-8.

A global call for talaromycosis to be recognised as a neglected tropical disease

Shanti Narayanasamy  1 , Vu Quoc Dat  2 , Nguyen Tat Thanh  3 , Vo Trieu Ly  4 , Jasper Fuk-Woo Chan  5 , Kwok-Yung Yuen  5 , Chuanyi Ning  6 , Hao Liang  6 , Linghua Li  7 , Anuradha Chowdhary  8 , Sirida Youngchim  9 , Khuanchai Supparatpinyo  10 , Ne Myo Aung  11 , Josh Hanson  12 , Alex Andrianopoulos  13 , John Dougherty  1 , Nelesh P Govender  14 , David W Denning  15 , Tom Chiller  16 , Guy Thwaites  17 , H Rogier van Doorn  17 , John Perfect  1 , Thuy Le  18
Affiliations
Review

A global call for talaromycosis to be recognised as a neglected tropical disease

Shanti Narayanasamy et al. Lancet Glob Health. 2021 Nov.

Abstract

Talaromycosis (penicilliosis) is an invasive mycosis that is endemic in tropical and subtropical Asia. Talaromycosis primarily affects individuals with advanced HIV disease and other immunosuppressive conditions, and the disease disproportionally affects people in low-income and middle-income countries, particularly agricultural workers in rural areas during their most economically productive years. Approximately 17 300 talaromycosis cases and 4900 associated deaths occur annually. Talaromycosis is highly associated with the tropical monsoon season, when flooding and cyclones can exacerbate the poverty-inducing potential of the disease. Talaromycosis can present as localised or disseminated disease, the latter causing cutaneous lesions that are disfiguring and stigmatising. Despite up to a third of diagnosed cases resulting in death, talaromycosis has received little attention and investment from regional and global funders, policy makers, researchers, and industry. Diagnostic and treatment modalities remain extremely insufficient, however control of talaromycosis is feasible with known public health strategies. This Viewpoint is a global call for talaromycosis to be recognised as a neglected tropical disease to alleviate its impact on susceptible populations.

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Conflict of interest statement

Declaration of interests NPG reports grants from US National Institutes of Health, US Centers for Disease Control and Prevention, the CDC Foundation, the Bill & Melinda Gates Foundation, the UK Medical Research Council, and the South African National Health Laboratory Service Research Trust, outside the submitted work. JF-WC and K-YY have an issued patent on antibodies targeting T marneffei Mp1p proteins and their methods of use. JP reports grants from Merck, Astellas, Pfizer, Amplyx, and Minnetronix; and membership on advisory boards or consulting roles for Merck, Amplyx, Minnetronix, F2G, Scynexis, Ampili, and Matinas, outside the submitted work. TL reports research funding from Gilead Sciences, outside the submitted work. All other authors declare no competing interests.

Figures

FIGURE 1:
FIGURE 1:
Geographic distribution of talaromycosis according to income status and climate zones
FIGURE 2.
FIGURE 2.
Upper and lower respiratory tract manifestations of talaromycosis. a) Computed tomography (CT) Angiogram of the neck demonstrating an ill-defined mass along the right lateral aspect of the hypopharynx involving the base of the tongue, right lingual tonsil, and right vallecula extending along the right palatine tonsil and into the pharyngeal space, in a 63 year-old man with HIV, b) Axial CT Chest demonstrating multiple disseminated ground glass opacities and bullae in a 34 year old immunocompromised female with a STAT3 mutation, c) Chest CT with interstitial infiltrates and nodules in a 57-year-old non-HIV-infected man with a history of prolonged steroid use.
FIGURE 3:
FIGURE 3:
Disfiguring skin lesions in talaromycosis. a) Typical disfiguring central-umbilicated skin lesions on the face of a patient with advanced HIV and disseminated talaromycosis in Vietnam, b) Talaromycosis cutaneous lesions in the lower extremities in another patient with HIV in Vietnam.
See this image and copyright information in PMC

References

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Appendix References

    1. Singh A, Atallah S, Al-Shyoukh A, DaCunha M, Mizusawa M. Localized Talaromyces marneffei infection presenting as a tonsillar mass mimicking malignancy. IDCases 2020; 21: e00824. - PMC - PubMed
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    1. Qin Y, Huang X, Chen H, et al. Burden of Talaromyces marneffei infection in people living with HIV/AIDS in Asia during ART era: a systematic review and meta-analysis. BMC Infect Dis 2020; 20(1): 551. - PMC - PubMed

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